Clinical application of wire-guided percutaneous transhepatic biliary drainage / 中华消化内镜杂志

ABSTRACT

Objective To evaluate the feasibility and safety of guidewire guidance method in percutaneous transhepatic biliary drainage (PTBD). Methods A total of 174 consecutive patients with biliary diseases who underwent PTBD in Heilongjiang Provincial Hospital from January 2011 to December 2017 were enrolled in this retrospective study. There were 85 patients undergoing conventional PTBD ( the conventional group), and 89 wire-guided PTBD (the wire-guided group). In the wire-guided group, the contrast media was not injected immediately after puncture, on the contrary, the needle coat was inserted deeply along the bile duct thereafter, then the bile was extracted to reduce the pressure of bile duct, at last the contrast media was infused. The drainage success rate and incidence of cholangitis related with PTBD were compared between the two groups. Results The incidence of PTBD-related cholangitis of the wire-guided group was significantly lower compared with the conventional group [ 10. 1％ ( 9/89 ) VS 21. 2％( 18/85) ,χ2=5. 270, P=0. 022] , although the drainage success rate was not significantly different between the two groups [ 94. 4％ ( 84/89) VS 97. 6％ ( 83/85) ,χ2=1. 200, P=0. 273] . Conclusion Wire-guided PTBD may yield a similar success rate, but can reduce the incidence of cholangitis compared with conventional PTBD.